Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 4301058676 | MI |
NPI | 1013977115 |
---|---|
Provider Name | Elliott Weinhouse |
First Address | Southfield, MI 48033-3849 |
Second Address | Royal Oak, MI 48073-6770 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 20/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B57523 | (02) |